Neuromuscular Physiotherapy Intervention for Right-Sided Monoparesis Following Nonhemorrhagic Stroke: An Inpatient Case Report

Abstrak

Background: Stroke can cause motor, sensory, coordination, balance, and functional impairments. Monoparesis is an uncommon motor presentation that may complicate functional recovery and rehabilitation planning. 
Objective: This case report aimed to describe physiotherapy assessment, multimodal intervention, and observed short term functional changes in a patient with right sided monoparesis following nonhemorrhagic stroke during inpatient rehabilitation. 
Methods: A case report was conducted in a 50-year-old man with nonhemorrhagic stroke and right sided monoparesis. The patient had a history of smoking and was independent in mobility and activities of daily living before stroke onset. Two individual physiotherapy sessions were delivered on 18 and 20 April 2026, lasting 30 and 40 minutes, respectively. 
Results: After the two sessions, pain sensation became detectable in the shoulder and elbow regions. Elbow strength increased from Manual Muscle Testing grade 3 to 4, while shoulder and wrist strength remained at grade 2. Berg Balance Scale score increased from 30 to 38 and Barthel Index from 50 to 60. National Institutes of Health Stroke Scale score remained 7, Hoffmann reflex remained positive, and coordination deficits persisted. 
Conclusion: Observed changes occurred across selected sensory, motor, balance, and functional domains. Because this was a single case with a short multimodal intervention, no comparator, and no follow up, the changes cannot be attributed specifically to physiotherapy or any individual intervention component.